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Eur J Trauma Emerg Surg · Apr 2022
Multicenter StudySeven-year excess mortality, functional outcome and health status after trauma in Hong Kong.
- Kevin Kei Ching Hung, Timothy H Rainer, Janice Hiu Hung Yeung, Catherine Cheung, Yuki Leung, Ling Yan Leung, Marc Chong, Hiu Fai Ho, Kwok Leung Tsui, Nai Kwong Cheung, and Colin Graham.
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
- Eur J Trauma Emerg Surg. 2022 Apr 1; 48 (2): 1417-1426.
PurposeThe purpose was to investigate long-term health impacts of trauma and the aim was to describe the functional outcome and health status up to 7 years after trauma.MethodsWe conducted a prospective, multi-centre cohort study of adult trauma patients admitted to three regional trauma centres with moderate or major trauma (ISS ≥ 9) in Hong Kong (HK). Patients were followed up at regular time points (1, 6 months and 1, 2, 3, 4, 5, 6, and 7 years) by telephone using extended Glasgow Outcome Scale (GOSE) and the Short-Form 36 (SF36). Observed annual mortality rate was compared with the expected mortality rate estimated using the HK population cohort. Linear mixed model (LMM) analyses examined the changes in SF36 with subgroups of age ≥ 65 years, ISS > 15, and GOSE ≥ 5 over time.ResultsAt 7 years, 115 patients had died and 48% (138/285) of the survivors responded. The annual mortality rate (AMR) of the trauma cohort was consistently higher than the expected mortality rate from the general population. Forty-one percent of respondents had upper good recovery (GOSE = 8) at 7 years. Seven-year mean PCS and MCS were 45.06 and 52.06, respectively. LMM showed PCS improved over time in patients aged < 65 years and with baseline GOSE ≥ 5, and the MCS improved over time with baseline GOSE ≥ 5. Higher mortality rate, limited functional recovery and worse physical health status persisted up to 7 years post-injury.ConclusionLong-term mortality and morbidity should be monitored for Asian trauma centre patients to understand the impact of trauma beyond hospital discharge.© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.
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